NPI | 1265926679 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 4704247277) |
Additional Taxonomies | 363LP2300X Nurse Practitioner Primary Care (Licence: MI 4704247277) |
Enumeration Date | 2018-06-19 |
Last Update Date | 2023-03-06 |